儿童腺样体和扁桃体肥大治疗理念新进展

doi:10.13701/j.cnki.kqyxyj.2021.08.005

摘要/Abstract

摘要： 儿童长期上气道阻塞或功能紊乱可以引起张口呼吸,产生腺样体面容,严重时导致阻塞性睡眠呼吸暂停低通气综合征(OASHS),严重影响儿童的生长发育和认知。腺/扁桃体肥大是儿童上气道阻塞的主要原因,其病理性肥大的生长规律和转归长期困扰着治疗方法的选择。本文讨论了儿童上气道阻塞对颌面部及全身生长发育的影响、不同治疗方法的选择及最新研究进展。

关键词: 腺样体肥大, 扁桃体肥大, 治疗, 阻塞性睡眠呼吸暂停低通气综合征

Abstract: Chronic upper airway obstruction or dysfunction in children can cause open mouth breathing, produce adenoid face, and in severe cases lead to obstructive sleep apnea hypopnea syndrome (OASHS), which can seriously affect the children's growth, development, and cognition. Adenoid and tonsil hypertrophy are the main cause of upper airway obstruction in children. This paper discusses the effects of upper airway obstruction on maxillofacial and systemic growth in children, the selection of different treatment methods, and the latest research progress. Children with upper airway obstruction require multidisciplinary cooperative sequential therapy.

Key words: adenoid hypertrophy, tonsil hypertrophy, treatment, obstructive sleep apnea-hypopnea syndrome

赵佳奇, 单丽华. 儿童腺样体和扁桃体肥大治疗理念新进展[J]. 口腔医学研究, 2021, 37(8): 693-695.

ZHAO Jiaqi, SHAN Lihua. New Progress in the Treatment of Adenoid and Tonsil Hypertrophy in Children[J]. Journal of Oral Science Research, 2021, 37(8): 693-695.

参考文献

[1] Pereira L, Monyror J, Almeida FI, et al. Prevalence of adenoid hypertrophy: A systematic review and meta-analysis[J]. Sleep Med Rev, 2018, 38:101-112.
[2] Ishida T, Manabe A, Yang SS, et al. Patterns of adenoid and tonsil growth in Japanese children and adolescents: A longitudinal study[J]. Sci Rep, 2018, 8(1):17088.
[3] Chambi-Rocha A, Cabrera-Domínguez ME, Domínguez-Reyes A. et al. Breathing mode influence on craniofacial development and head posture[J]. J Pediatr (Rio J), 2018, 94(2):123-130.
[4] Baroni M, Ballanti F, Polimeni A, et al. Thin-plate spline analysis of craniofacial morphology in subjects with adenoid or tonsillar hypertrophy[J]. Int J Pediatr Otorhinolaryngol, 2011, 75(4):518-522.
[5] Gao W, Li J, Li Q, et al. CYSLTR1 promotes adenoid hypertrophy by activating ERK1/2 [J]. Exp Ther Med, 2018, 16(2):966-970.
[6] Dayyat E, Serpero LD, Kheirandish-Gozal L, et al. Leukotriene pathways and in vitro adenotonsillar cell proliferation in children with obstructive sleep apnea[J]. Chest, 2009, 135(5): 1142-1149.
[7] Cengel S, Akyol MU. The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy[J]. Int J Pediatr Otorhinolaryngol, 2006, 70(4):639-645.
[8] 匡嘉丽,李健,陆洋,等. 腺样体肥大治疗的前瞻性随机对照研究[J]. 中山大学学报(医学科学版),2012,33(3):373-377.
[9] 钱南南, 王文忠.手术和药物治疗儿童腺样体肥大的临床疗效观察[D]. 2017, 蚌埠医学院.
[10] Marcus CL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome[J]. Pediatrics, 2012, 130(3):e714-e755.
[11] Reckley LK, Fernandez-Salvador C, Camacho M. The effect of tonsillectomy on obstructive sleep apnea: an overview of systematic reviews[J]. Nat Sci Sleep, 2018, 10:105-110.
[12] Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea[J]. N Engl J Med, 2013, 368(25) :2366-2376.
[13] Esteller E, Villatoro JC, AgÜero A, et al. Obstructive sleep apnea syndrome and growth failure[J]. Int J Pediatr Otorhinolaryngol, 2018, 108: 214-218.
[14] Venekamp RP, Hearne BJ, Chandrasekharan D, et al. Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children[J]. Cochrane Database Syst Rev, 2015,(10):CD011165.
[15] Be B, Jp V, Sm K, et al. Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis [J]. Eur J Orthod, 2017, 39(5):509-518.
[16] 杨远芳,贾莹,刘娟,等.非阻塞性口呼吸错牙合畸形儿童的口腔综合治疗[J]. 贵州医科大学学报,2019,44(6): 708-711.
[17] Zhang C, He H, Ngan P. Effects of twin block appliance on obstructive sleep apnea in children: a preliminary study[J]. Sleep Breath, 2013, 17(4):1309-1314.
[18] Iwasaki T, Takemoto Y, Inada E, et al. Three-dimensional cone-beam computed tomography analysis of enlargement of the pharyngeal airway by the Herbst appliance[J]. Am J Orthod Dentofacial Orthop, 2014, 146(6):776-785.
[19] Ashok N, Varma NK, Ajith VV, et al. Effect of rapid maxillary expansion on sleep characteristics in children[J]. Contemp Clin Dent, 2014, 5(4):489-494.